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De Melo Pompei L.,Gynecological Endocrinology | Giribela A.G.,University of Sao Paulo | Giribela C.G.,University of Sao Paulo
Women's Health | Year: 2011

Considerable advances have been made in the field of combined oral contraceptives since their introduction 50 years ago. This ongoing evolution has been focused on reducing the estrogen dose and synthesizing new progestogens. A recently launched combination of ethinylestradiol 20 μg and drospirenone 3 mg demonstrates the advantages of a lower estrogen dose with the antimineralocorticoid activity of drospirenone that is responsible for the drug's significant antiandrogenic and antimineralocorticoid effects, reflected clinically in lower rates of adverse events including less fluid retention. In addition to the drugs contraceptive efficacy, its effects on the skin and other classic noncontraceptive benefits, the ethinylestradiol 20 μg and drospirenone 3 mg combination has demonstrated highly satisfactory results in women with premenstrual dysphoric syndrome. © 2011 Future Medicine Ltd. Source

Lello S.,Gynecological Endocrinology | Cavani A.,Laboratory of Experimental Immunology
International Journal of Endocrinology | Year: 2014

Estroprogestins (EPs) are combinations of estrogen and progestin with several actions on women's health. The different pharmacological composition of EPs is responsible for different clinical effects. One of the most used low-dose EP associations is ethinylestradiol 20 mcg plus levonorgestrel 100 mcg in monophasic regimen (EE20/LNG100). This review summarizes clinical pharmacology, cycle control, and effects on lipid and glucose metabolism, coagulation, body weight/body composition, acne, and sexuality of EE20/LNG100. Overall, EE20/LNG100 combination is safe and well tolerated, and in several studies the incidence of adverse events in the treated group was comparable to that of the placebo group. Cycle control was effective and body weight/body composition did not vary among treated and untreated groups in most studies. The EE20/LNG100 combination shows mild or no effect on lipid and glucose metabolism. Lastly, EE20/LNG100 is associated with a low risk of venous thromboembolism (VTE). In conclusion, in the process of decision making for the individualization of EPs choice, EE20/LNG100 should be considered for its favorable clinical profile. © 2014 Stefano Lello and Andrea Cavani. Source

Palacios S.,Instituto Palacios | Christiansen C.,Nordic Bioscience | Sanchez Borrego R.,DIATROS Clinica de Atencion a la Mujer | Gambacciani M.,University of Pisa | And 9 more authors.
Gynecological Endocrinology | Year: 2012

The risk for fragility fracture represents a problem of enormous magnitude. It is estimated that only a small fraction of women with this risk take the benefit of preventive measures. The relationship between estrogen and bone mass is well known as they are the other factors related to the risk for fracture. There are precise diagnostic methods, including a tool to diagnose the risk for fracture. Yet there continues to be an under-diagnosis, with the unrecoverable delay in instituting preventive measures. Women under the age of 70 years, being much more numerous than those older, and having risk factors, are a group in which it is essential to avoid that first fragility fracture. Today it is usual not to differentiate between the treatment and the prevention of osteoporosis since the common aim is to prevent fragility fractures. Included in this are women with osteoporosis or with low bone mass and increased risk for fracture, for whom risk factors play a primary role. There is clearly controversy over the type of treatment and its duration, especially given the possible adverse effects of long-term use. This justifies the concept of sequential treatment, even more so in women under the age of 70, since they presumably will need treatment for many years. Bone metabolism is age-dependent. In postmenopausal women under 70 years of age, the increase in bone resorption is clearly predominant, related to a sharp drop in estrogens. Thus a logical treatment is the prevention of fragility fractures by hormone replacement therapy (HRT) and, in asymptomatic women, selective estradiol receptor modulators (SERMs). Afterwards, there is a period of greater resorption, albeit less intense but continuous, when one could utilise anti-resorptive treatments such as bisphosphonates or denosumab or a dual agent like strontium ranelate. Bone formation treatment, such as parathyroid hormone (PTH), in women under 70 years will be uncommon. That is because it should be used in cases where the formation is greatly diminished and there is a high risk for fracture, something found in much older women. © 2012 Informa UK, Ltd. Source

Lipinskaa J.,Gynecological Endocrinology | Stefanowicz M.,Gynecological Endocrinology | Wasniewski T.,Gynecological Endocrinology | Lukaszuk K.,Gynecological Endocrinology
Polish Annals of Medicine | Year: 2013

Introduction: Vulvar cancerisararetypeofcancer. InPolandin2010therewere491casesof vulvar cancer. Prognosticfactorsthatmayinfluence thecourseofthediseaseandresults of treatmentcanbedividedintofactorsassociatedwithtumor,individualfactorsofthe patient (age,socioeconomicstatus,co-morbidities,bodyweight,motivationtocomply) and environmental factors. Aim: The purposeofthisresearchwastoevaluatetheimpactofindividualandenviron- mental factorsontheprognosisofwomenwithvulvarcancer,regardlessoftheclinical stage. Material andmethods: The studygroupconsistedof48patientswithinvasivesquamouscell carcinoma ofthevulvatreatedsurgicallyintheDepartmentofGynecologicalOncologyin Olsztyn in1995-2008. Analysisincludedage,placeofliving,occupationalstatus, marital status, obstetrichistory,co-morbidities,bodyweight,andhealingofpost- operativewound. Univariate analysisoftheeffectofthesefactorsonsurvivalandrecurrencerateswas performed. Results anddiscussion: Univariate analysisshowedarelationshipbetweenimpairedpost- operative woundhealingandrecurrencerate(p>.05). Woundhealingcomplicatedby abscess formationoccurredmostfrequentlyinpatientswithT2stagetumoranddidnot correlate withlymphnodeinvolvement.Noeffectofage,bodyweight,ageatmenarche and ageatmenopause,andnumberofbirthsonthepresenceorabsenceofrecurrencewas observed (p>.05). Conclusions: In patientswithpost- operativewoundhealingcomplicationsduetoinfection statisticallysignificantworsesurvivalrateshavebeenobserved. Vulvarcancerwasrepeat- edlydiagnosed22yearsaftermenopause, initsadvancedstages(accordingtoFIGO1988).No correlationbetweensurvivalrateanddemographicfactors,environmentalfactors,gyneco- logicalandobstetrichistoryandco-morbiditieswasdemonstrated.Differencebetween overallsurvivalanddisease-specific survival,thatis, excludingdeathsfromcausesunrelated to cancer,was10%. © 2013 Warmin'sko-Mazurska IzbaLekarskawOlsztynie. Source

De Seta F.,University of Trieste | Restaino S.,University of Trieste | Banco R.,University of Trieste | Conversano E.,University of Trieste | And 5 more authors.
Gynecological Endocrinology | Year: 2014

Estroprogestins with "natural oestrogen" has represented a new option in terms of combined hormonal contraception. So, the aim of this study is to investigate how estroprogestins with natural estrogen may modify the vaginal niche. In literature, very few studies focused on the interaction between hormonal contraception and vaginal milieu. This is a prospective comparative study. We enrolled 60 women from January 2013 to September 2013, 30 of them were administered estradiol valerate dienogest (E2V+DNG-Klaira®) in a quadriphasic regimen, while the other 30 women were administered 17-β estradiol with nomestrol acetate (EV+NOMAC-Zoely®) in a monophasic regimen. After a baseline study of vaginal milieu at recruitment of patients (Gram stain with Nugent score, vaginal pH, vaginal wet mount for the quantification of leukocytes, Lactobacilli and/or presence of Candida), we performed the same follow-up after six months of estroprogestin therapy. Our results showed that the women treated with E2V+DNG had a trend of an improvement of vaginal health in terms of increase of lactobacillar flora and reduction of vaginal pH in place of women treated with EV+NOMAC that showed a reduction of cervical mucus. Finally, our data about the effects on vaginal flora exerted by two estroprogestin pills (EPs) containing a natural estrogen suggest slight, but interesting differences in terms of vaginal ecology. These differences could be related to the type of estrogen, type of progestin, regimen of administration and, after all, to the net balance between estrogenic and progestin component of the EPs. © 2014 Informa UK Ltd. All rights reserved. Source

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